Drug and nutrient interactions

Question 1

Birth control/contraceptives

Answer 1

depletion of b vitamins
contrac w/estrogen (folate B9) , vitamin A, Vitamin C

Estrogen : accelerate calcium and magnesium deposition from bone

Question 2

cholesterol, Heart

Answer 2

ACE inhibitors (hypertension)
-Inhibits iron
-depletes zinc
-hold potassium (Hyperkalemia)

Amlodipine: Calcium channel blockers: (Hypertension)
- watch grapefruit and pomegranate (CYP450, CYP3A4) : increases level of drug.

ART: antiretroviral
St. Johns wart, and garlic (decreases efficacy)

Atorvastatin ( cholesterol)
-depletes coQ10, Metformin, B12, Vitamin D
-COmpetes with PPI
-grapefruit: increases serum, induces CYP3A4
-St Johns Wart: increases LDL
-Red yeast rice: similar to statin
-HMG-C0A reducates (Lipitor)
-inhibits CoQ10

Anticoagulants (warfarin, coumadin)
-competes with vitamin K
-also affected by high doses vitamin E
-Gingko Biloba : potentiates action of anticoagulants.
-Black Current : ANtithrombonic
Interfere with D activation and ostepblast function

Beta Blockers: (antihypertensive)
-coQ10, melatonin
-chelates/absorption of calcium

Hypocholesterolemics :
Lower absorption of vitamin B12, binds bile acid, cholesterol, bile salts, nutrients, lower digestion/absorption of fatty acid, fat sol, vitamins, iron, b-carotene.
0clofibrate: B12, Vitamin A, D, E
-Colestipol: binds promotes bile acid excretion, lower fatty acid/fat-sol vitamin absorption.

Question 3

Antihypertensives (methyldopa)

Answer 3

INHIBIT ENZ REQB6 , inhibits coQ10, grapefruit increases

Question 4

Immune, cancer

Answer 4

anthracyclines/chemo
-CoQ10

methotrexate (cancer, RA)
Folate antagonist, B12, calcium,

Question 5

anitbiotics (tetracylcines, amoxicillin

Answer 5

magnesium, vitamin K
Iron, b vitamins, k, calcium, zinc, magnesium, probiotics.

Question 6

anticonvulsants (antiseizures)

Answer 6

impairs bioavailability of vitamin D, Folate, B7, B12, vitamin C,
lowers ca absorption
St johns wort

Question 7

antitubercular

Answer 7

inhibits conversion of tryptophan>niacin

Question 8

antimicrobial

Answer 8

inhibits absorption of FA< AA< Ca, Na, K, folate, vitamin B12 , iron

inhibits mucosal uptale of folate.

Question 9

antiinflammatory drugs (aspirin) NSAIDS

Answer 9

iron
melatonin, zinc,
antiinflammatory (folate)

Question 10

glucocorticoids: medicines that fight inflammation

Answer 10

inhibit calcium and folate
accelerate bone mineralization

Question 11

corticosteroids (hydrocortisone)

Answer 11

imprairs vitamin D bioavalability
folate

Question 12

analgesic acetaminophen(tylenol)

Answer 12

alcohol,
N-acetylcysteine is used to combat tylenol/ carbon monoxide posioning

Question 13

Gastrointestinal/Antacids

Answer 13

PPI (reduces gastric acid secretion leading to B12 deficiency)
-B12, folate (after 3 years)
Calcium, iron zinc, mg, b1

Long term use : IBS, osteoporosis, SIBO
p. anemia
H.Pulori
Vitamin A/E/D/K (fat malabsorption)

Question 14

H2blockers (ranitidine/zantac)

Answer 14

calcium weakens bones
folate
inhibits vitamin D absorption

Question 14

Anti-gout

Answer 14

induces b12 malabsorption

Question 14

Antidepressants
MAO inhibitors

Answer 14

interacts with Tyramine
(anchovies, chocolate, meat extracts, sour cream, raspberry, fermented products, aged cheeses, soy, wine,
-increases risk for hypertension

vasopressor agents in foods (avoid w MAO)

Question 15

Antipsychotics

Answer 15

coQ10

Question 16

Antidepressents (tricyclic)

Answer 16

dry mouth and tooth decay
CoQ10

Question 17

SSRI

Answer 17

melatonin
folate
avoid: tryptophan/5-HTP, SAM-e, Kava Kava, SJW

Question 18

Barbiturates (sedatives, sleep )

Answer 18

impairs vitamin D
folate

Question 19

Diuretics

Answer 19

calcium, zinc, folic acid
inhibits potassium (K)

Also Thiamin B1, Mg

Question 20

potassium repletion

Answer 20

inhibits B12 absorptiom

Question 21

laxatives

Answer 21

decreases: ca, K, b-carotene , vitamin A, Vitamin K
decreases vitamin D

Question 22

albuterol

Answer 22

calcium, mg, potassium

Question 23

hypoglycemics (metformin)

Answer 23

B12, Folic acid (b9)
liver

Question 24

levothyroxine

Answer 24

calcium/coffee: decreases absorption
vitamin C: increases absorption
grapefruit: decreases absirption